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VUMC poised to meet health care’s challenges

Jun. 20, 2013, 9:24 AM

Jeff Balser, M.D., Ph.D., discusses Vanderbilt’s response to the nation’s evolving health care landscape during Wednesday’s Clinical Enterprise Leadership Development Assembly. (photo by John Russell)

The nation’s health care challenges are immense, and Vanderbilt University Medical Center is rising to meet them — with an emphasis on integration, collaboration, and by improving efficiency, quality and service to its patients.

That was the message Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the Vanderbilt University School of Medicine, delivered Wednesday during the quarterly Clinical Enterprise Leadership Assembly in Langford Auditorium.

The nation’s health care sector is shrinking — according to the U.S. Bureau of Labor Statistics, 6,000 hospital jobs were lost in May — due in large part to cutbacks in health care payments from commercial as well as government payors.

In response and to achieve greater efficiency, the nation’s 6,000 hospitals are likely consolidating into what eventually will become about 400 large, integrated health care “systems.”

In less than two years, for example, Vanderbilt has affiliated with more than 30 hospitals, a quarter of all the hospitals in Tennessee. The alliance, representing nearly 3,000 hospital beds, is “leading and defining what health care looks like in our region,” Balser said.

The federal government also is cutting its support of medical education and biomedical research. Partially in response to economic pressures, and to make education and training opportunities more personalized, Vanderbilt will be slightly reducing the size of its incoming medical school class, the number of students seeking graduate degrees in the biomedical sciences and physicians for residency training.

Vanderbilt’s innovations in medical education, Curriculum 2.0, which expose students to the clinical environment beginning in their first year, and which focus on training leaders in health care and biomedical science, are attracting national attention — and financial support.

The School of Medicine received 5,830 applicants for an entering class of 96 this fall — a better than 66 percent increase since 2003. It also received a $1 million grant from the American Medical Association in recognition of its efforts to transform medical education.

Vanderbilt also intends to remain a leader in training the next generation of scientists and in making discoveries that are “of fundamental importance to humanity,” Balser said. Some programs that do not have adequate support will be downsized, but others will be grown, and capital investments will be reprioritized.

On the clinical side, outpatient visits are up. Hospital discharges are up. But so is percentage of patients – up more than 2 percent this year — who are covered by Medicare, which pays less than private insurance.

To continue to lead in this environment, the Medical Center will cut 3.3 percent from its budget — $100 million — in the next fiscal year that begins July 1, said C. Wright Pinson, MBA, M.D., deputy vice chancellor for Health Affairs and CEO of the Vanderbilt Health System.

In his quarterly “Pillar” update, Pinson asked every employee — staff and faculty — to help improve efficiency and productivity, quality and service. “There is no way for us to avoid the fact. We’ve got to make ourselves leaner,” he said. “We have to work smarter.”

Suggestions for doing just that can be submitted to the Vice Chancellor’s suggestion box at

Balser concluded the Assembly by showing the recent Tim McGraw music video produced at Vanderbilt, “Highway Don’t Care,” about the dangers of distracted driving. That, he said, is yet another example of Vanderbilt’s commitment to improving the health of all people.

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